Fran (30) is a mother of two children: Katlin (14) and Oisin (4 months). The family lives in a two-bedroom flat. Adam (34), the father of Oisin, works as a security guard. He works night shifts and often comes back to the flat to sleep during the day. Fran is unemployed, and does not like leaving the house.

Katlin is in Year 10 of the local high school. She was born prematurely at 32 weeks and has mild learning difficulties. She has an Education and Healthcare Plan to support her to stay in mainstream education. However, she is often reported by teachers to be disengaged, tired and withdrawn in class. She doesn’t have a big circle of friends and teachers have noted she is often isolated. Katlin has diabetes and was diagnosed aged 4 years. She has been having repeated admissions to hospital for poorly controlled blood sugar levels and is not compliant with her insulin regime.

Oisin is a small baby, whose weight at his post-natal check was measured on the 0.4th centile. He has not been taken to any further post-natal appointments. Fran called an ambulance for Oisin two weeks ago as he was ‘floppy’ and ‘not himself’. Oisin was admitted to the ward from accident and emergency due to malnutrition and dehydration. Fran is keen to get him discharged as she wants to be back at home; however, the nurses on the ward have concerns about Fran’s capacity to care for Oisin.

• What are the safeguarding concerns?

Answer: Fran is a vulnerable adult as she does not like leaving the house. Katlin is disengaged in school, diabetes control is poor and she is isolated. Oisin is failing to thrive due to potential lack of feeding.

• What categories of abuse are relevant to this case study?

Answer: Potentially neglect and emotional abuse.

The Child Exploitation and Online Protection Centre (CEOP) published a thematic assessment to increase understanding of child sexual exploitation. The aim of this research was to raise awareness and knowledge to enhance prevention by understanding patterns of offenders, victimisation and vulnerability of children and young people to sexual exploitation.

The full assessment can be accessed online at:

www.nationalcrimeagency.gov.uk/publications/49-ceop-institutions-thematic-assessment/file

Further information can be found at:

www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/child-sexual-e...

• Highlight the main findings from this evidence.

Possible answers

Conclusions and lessons learnt:

1. Offenders are younger than thought with a large majority being 25 years of age or under.
2. Offenders enjoy the power and control and the status this brings and sometimes carry out these acts purely for this reason.
3. Local Safeguarding Children’s Boards must have clear guidelines and up to date policies on sexual exploitation and initiate an effective multi-agency working approach.
4. Clear protocols are needed for information sharing.
5. Specialist training for front line workers to ensure knowledge of how to spot a vulnerable child or young person is available.

Amisha was a 19-year-old woman who had a troubled upbringing. She was first made homeless at the age of 13 and had ‘sofa surfed’ from then onwards. She was in and out of education and had contact with the local IAPT (Improving Access to Physiological Therapies) team for most of her adolescence. Amisha was known by two different General Practitioners and she was constantly struggling to fight addiction to both alcohol and drugs. During this time she had a referral to a consultant psychiatrist to make a full mental health assessment to meet her needs. Housing were providing input to assist in her finding accommodation in a privately rented accommodation. At this point Amisha attended the GP to state that she was pregnant. She also saw the drug rehabilitation team and the psychiatrist in the same week. She disclosed her housing and financial difficulties to all professionals. However she stated that she was not taking drugs or drinking as she was happy to be pregnant. Amisha was allocated a midwife and the midwife received no history on Amisha and relied only on what was told her.

During the later stages of her pregnancy the specialist midwife for supporting vulnerable mothers documented that a referral may be needed. However this was never carried out. Baby was born to Amisha but died aged 2 day. At post-mortem, unlicensed drugs were found in her system. These drugs most likely passed through the placenta or breastmilk (Wonnacott, 2013).

Consider the above case study:

• What are some of the lessons learnt from this case study?

Answer:

1. Health visiting service to provide targeted antenatal checks
2. Use of community mental health teams
3. Lack of information sharing between professionals
4. The drug and alcohol team didn’t share information as Amisha stopped attending the service
5. Increased awareness of the impact of drug use on babies pre and post birth.
6. Use in practice of current knowledge relating to the impact of mental health, drug use and domestic violence on parenting

• What does the literature say in relation to information sharing?

Answer:

1. Consideration needs to be given to how information is shared between professionals
2. Amisha needed a social worker
3. Amisha needed a lead professional to collaborate the information between professionals
4. Access to adult social care information within the MASH